title: Computer-assisted spinal osteotomy: a technical note and report of four cases.
abstract: METHODS
  A report of 4 cases of spinal osteotomy performed under the guidance of a computer-assisted navigation system and a technical note about the use of the navigation system for spinal osteotomy.
  
  
  OBJECTIVE
  To document the surgical technique and usefulness of computer-assisted surgery for spinal osteotomy.
  
  
  BACKGROUND
  A computer-assisted navigation system provides accurate 3-dimensional (3D) real-time surgical information during the operation. Although there are many reports on the accuracy and usefulness of a navigation system for pedicle screw placement, there are few reports on the application for spinal osteotomy.
  
  
  METHODS
  We report on 4 complex cases including 3 solitary malignant spinal tumors and 1 spinal kyphotic deformity of ankylosing spondylitis, which were treated surgically using a computer-assisted spinal osteotomy. The surgical technique and postoperative clinical and radiologic results are presented.
  
  
  RESULTS
  3D spinal osteotomy under the guidance of a computer-assisted navigation system was performed successfully in 4 patients. All malignant tumors were resected en bloc, and the spinal deformity was corrected precisely according to the preoperative plan. Pathologic analysis confirmed the en bloc resection without tumor exposure in the 3 patients with a spinal tumor.
  
  
  CONCLUSIONS
  The use of a computer-assisted navigation system will help ensure the safety and efficacy of a complex 3D spinal osteotomy.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. shfuji@kuhp.kyoto-u.ac.jp
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Fujibayashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Neo
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Takemoto
authors.forename: Masato
authors.initials: M
authors.lastname: Ota
authors.forename: Tomitaka
authors.initials: T
authors.lastname: Nakayama
authors.forename: Junya
authors.initials: J
authors.lastname: Toguchida
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002813:Chondrosarcoma / Q000601:surgery; D005260:Female; D005354:Fibrosarcoma / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D013121:Spinal Curvatures / Q000601:surgery; D013125:Spinal Neoplasms / Q000601:surgery*; D013167:Spondylitis, Ankylosing / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*